Provider Demographics
NPI:1275250136
Name:HILKE, NATASHA (AGPCNP)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HILKE
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1129 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WI
Mailing Address - Zip Code:54968-9242
Mailing Address - Country:US
Mailing Address - Phone:920-517-3374
Mailing Address - Fax:
Practice Address - Street 1:1129 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WI
Practice Address - Zip Code:54968-9242
Practice Address - Country:US
Practice Address - Phone:920-517-3374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13242-33363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology